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Cruz MJ, Curull V, Pijuan L, Álvarez-Simón D, Sánchez-Font A, de Gracia J, Culebras M, Ferrer J. Utility of Bronchoalveolar Lavage for the Diagnosis of Asbestos-Related Diseases. Arch Bronconeumol 2016; 53:318-323. [PMID: 27914752 DOI: 10.1016/j.arbres.2016.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 08/14/2016] [Accepted: 08/16/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bronchoalveolar lavage (BAL) analysis has been proposed as an objective technique for confirming asbestos exposure. However, the reliability and diagnostic yield of this procedure has not been studied in Spain. The aim of this study was to assess the usefulness of the analysis of asbestos bodies (AB) in bronchoalveolar lavage (BAL) for the diagnosis of asbestos-related diseases (ARD). METHODS BAL samples from 72 patients (66 male, mean age 66 years) undergoing bronchoscopy were analyzed. Lung tissue from 23 of these patients was also analyzed. Asbestos exposure was assessed by anamnesis and a review of the patient's medical records. BAL and lung samples were processed and AB count was determined by light microscopy. The accepted threshold value to diagnose asbestos-related diseases was 1 AB/ml BAL or 1000 AB/gr dry tissue. RESULTS Thirty-nine patients reported exposure to asbestos. Of these, 13 (33%) presented AB values above 1 AB/ml BAL. In the 33 non-exposed patients, 5 (15%) presented AB values above 1 AB/ml BAL. There was a significant difference between the AB levels of exposed and non-exposed patients (P=.006). The ROC curve showed that a value of 0.5 AB/ml BAL achieved the most satisfactory sensitivity, 46%, and a specificity of 83%. The correlation between AB levels in BAL and lung was 0.633 (P=.002). CONCLUSIONS BAL study provides objective evidence of exposure to asbestos. The good correlation between the AB counts in BAL and lung tissue indicates that both techniques are valid for the analysis of asbestos content.
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Affiliation(s)
- María Jesús Cruz
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Victor Curull
- Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Lara Pijuan
- Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Daniel Álvarez-Simón
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Albert Sánchez-Font
- Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Javier de Gracia
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Mario Culebras
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Jaume Ferrer
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
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